2/16/2018 12:00:00 PM

Dental implants are highly advertised dental treatments, which we also discuss at length on our website. But if you’re unfamiliar with this process, it pays to know the basics. To unpack the essential elements of this procedure, Dr. Okamoto has provided the following blog post.

In short, a dental implant is a complete replacement for a lost tooth – and that includes a substitute for the roots of a teeth. While crowns, bridges, and dentures (the prosthetics for replacing the visible parts of teeth) are important to overall treatment, a dental implant usually refers to the components listed below:

Post – This is a small appliance that looks like a screw and serves as the base of the implant. Dr. Okamoto places the post into the jaw bone so it can integrate with tissue and become a strong foundation for other pieces of the restoration. Implant posts are typically made of titanium, but advancements in implant technology have provided zirconia bases as well.

Abutment – This connecting piece serves as the coupling between the post and the visible prosthetic. The abutment can be made from metal or tooth-colored materials, depending on needs and preferences.

Established companies, such as Nobel or Zimmer, supply the post and abutment, while the implant restorations Dr. Okamoto adds to the abutment are usually created at an outside dental lab.
As much as a dental implant can replicate an entire natural tooth, implant posts can also be supports or anchors for larger restorations. One implant post, abutment, and crown can equal one whole tooth, but four dental implant posts, specialized attachments, and a bridge or denture can equal a complete arch of your smile.

Dental implants are flexible prosthetics that support dental health, function, and appearance. Their power comes from the post, which creates a replacement for missing tooth roots and stimulates bone over time. The definition of an implant can be complicated, but it may be best served by stating that an implant is a replacement tooth root and permanent base for aesthetic tooth replacement.

Ask Dr. Okamoto about Dental Implants!

If you’re looking for more information about implant procedures, we encourage you to read through our website or contact our office to speak to a member of our team. As a tooth replacement specialist, Dr. Okamoto has all the information necessary to help you make confident decisions about your treatment plan.

12/15/2017 12:00:00 PM

Dr. Steven Okamoto and Dr. Michelle Okamoto use modern technologies to enhance and restore patients’ smiles. What many patients don’t know, is the simple solution to a healthier smile may be hiding somewhere unexpected – in their pantry and medicine cabinet.

When our patients seek ways to improve their oral health, one of the simplest adjustments they can make is altering their diet to improve nutrition and ingest more vitamins and minerals.


Teeth and jaw bone are primarily comprised of calcium, which makes this supplement critical to your oral health. Foods high in calcium include:
  • Dairy
  • Broccoli
  • Leafy green vegetables
  • Sardines
  • Almonds
  • Oysters
If your diet alone does not provide enough calcium, it’s recommended that you add supplements to keep teeth strong.

Vitamin A
More commonly recommended for improving eyesight, Vitamin A also aids in oral health by promoting salivary production and preserving healthy mucous that eliminates harmful bacteria. Foods containing large amounts of vitamin A include:
  • Carrots
  • Sweet potatoes
  • Kale
  • Spinach
  • Peppers
  • Egg yolks
  • Fish
Vitamin B
Vitamin B works to fight off inflammation and soft tissue sores. In the event that you’re suffering from either, increasing your Vitamin B intake can help expedite the healing process. Foods high in vitamin B include:
  • Poultry
  • Fish
  • Red meat
  • Dairy
  • Spinach
  • Almonds
  • Legumes
Vitamin D
Vitamin D improves the body’s ability to absorb calcium. Without an adequate amount of Vitamin D, you run the risk of teeth under-developing or experiencing decay. Vitamin D can be found in the following foods:
  • Milk
  • Eggs
  • Fish
  • Cod Liver Oil
Potassium benefits the body by inhibiting substances that promote the breakdown of bones, as well as aiding in blood clotting. Patients concerned with obtaining enough potassium should consider eating the following foods:
  • Legumes
  • Squash
  • Yogurt
  • Milk
  • Cheese
  • Bananas
  • Avocados

Ask Okamoto DDS about Diet and Nutrition Tips for Better Health!

Our whole team is committed to the preservation of your oral health and can provide plenty of tips to get your smile back on track, beyond simple brushing and flossing tips. Want to learn more methods of improving the health of your smile? We welcome you to read some of our other articles, or contact our office today to schedule your New Patient Appointment.

10/24/2017 12:00:00 PM

While teeth bleaching products have been widely available for years, some patients are still hesitant to use them and are unsure if frequent whitening or even one-time use of the products will do anything to damage their smiles.

Effects of Whitening Gel on Dental Enamel

Bleaching gel is formulated to affect the surface or enamel of teeth and does not reach the pulp inside the tooth. Peroxide has not been shown to negatively affect teeth in the long term. According to studies, patients who whiten their teeth frequently are, not more likely to experience damage to their teeth than patients who do not.

Patients who are concerned about using whitening gel can choose to whiten their teeth less frequently or choose oral hygiene aids to improve tooth mineralization and strength. These hygiene products, usually rinses or toothpastes, typically contain fluoride. Diet can also affect the strength of teeth. Foods that are high in protein or whole grains can help make teeth more durable over time.

Peroxide whitening gel does not have an impact on soft tissue either. While gums are protected during professional whitening application, any whitening agent that makes contact with soft tissues will not have a negative effect on the appearance of gums or overall oral health.

Desensitizing Products

While thermal sensitivity doesn’t make teeth whitening unsafe or harmful, it can become problematic for cosmetic dentistry patients. Patients who whiten their teeth, either at a dental office or at home, may experience quick moments of discomfort after the application of whitening products. This issue will dissipate quickly after your whitening regimen has finished. However, if tooth sensitivity is of concern for you, there are over the counter products that minimize this effect.

Before a whitening program, patients can choose a toothpaste formulated for sensitive teeth. Most retailers carry special strips, which resemble typical whitening strips and are formulated to prevent thermal sensitivity. Depending on whether you choose to whiten your teeth at a dental office or at home, these strips can be applied by our dentists or by patients themselves.

Safe, Effective Teeth Whitening - Ask our Cosmetic Dentists

At Okamoto, DDS, the health and longevity of your smile is highly important to our entire team. We do not take risks with products or treatments and only provide services that will meet your expectations and preserve your health. For stunning whitening results with a safe dental bleaching program, contact our office today.

10/4/2017 12:00:00 PM

Having a strong and healthy jaw is important for overall dental wellness and even the aesthetics of your smile. To reinforce this structure, bone grafts are often performed after a tooth has been extracted or before dental implants are placed.

While developing your treatment plan, Dr. Okamoto determines if a bone graft will improve your dental health. If so, you have more than one choice available: synthetic, lab-created grafts or organic bone.

Minimally Invasive Care

You always have the option to have bone taken from areas that include the chin or thigh. As your own organic tissue, these grafts have a high likelihood of successfully bonding with surrounding tissue. However, taking that bone from elsewhere on your body creates a secondary treatment site.
Synthetic bone grafts are provided by a lab and can be placed directly at the site of the lost tooth or depleted bone volume. There is no need to create a secondary treatment area.

Safe and Sterile Grafting Procedures

While every measure is taken to ensure donor tissue added to your smile is safe and sterile, regardless of the material used, synthetic bone grafts are created in a sterile lab environment  and not taken from a donor. Donor bone must be processed to make it safe for grafting, but synthetic bone does not increase risk for health complications.

Your synthetic bone graft is created with the use of many different and biocompatible materials, including protein, growth factors, and white dental composite. This process minimizes the risk of rejection and irritation for patients who require bone augmentation before additional restorative dentistry can be performed.

Important Considerations

There are certainly many benefits to having a bone graft, no matter which material you choose – and every approach has its own unique benefits and considerations to take into account before you decide on a treatment method. Synthetic tissue creates a bridge or supportive framework that encourages bone to grow around and over it, in a manner similar to how a trellis directs plants to grow and spread in a desired location. On the other hand, organic bone expands from the area of placement on its own, growing naturally.

Both options create better support for teeth and implants, but one grafting material supports bone development while the other creates it.

If you have questions about dental grafting surgeries, don’t hesitate to call our office! We look forward to explaining all of the ways our team can help you enjoy a healthier smile.

9/26/2017 12:00:00 PM

Many patients who suspect they or a loved one have sleep apnea go straight to their primary care physician. While analysis and collaboration with your medical care provider are important, you can also seek diagnosis and treatment from our dentist.

In the treatment of obstructive sleep apnea, our dental office is helpful in providing care that is convenient and effective.

Easy, At-Home Diagnosis

In traditional treatment processes, patients visit a specialist to have their sleeping patterns monitored. While this provides necessary sleep data, it disrupts your normal routine and requires that you spend an evening trying to fall asleep in a clinical testing facility.

Our dental office provides technology that allows you to skip the overnight stay at an outside sleep study office and rest in your own bed. This equipment collects the same necessary data as an outside sleep study, helping to determine factors that include oxygen levels in blood. Once this information has been gathered, it is sent to a sleep specialist for analysis to determine causes of sleep apnea and severity of the condition.

Comfortable Appliances

As dental professionals, Drs. Steven and Michelle Okamoto are skilled in producing oral appliances which treat conditions that manifest in the mouth or damage teeth and soft tissue. In cases of obstructive sleep apnea, these appliances create an easy flow of air and unobstructed breathing. In comparison with a CPAP machine that pushes air into and through a patient’s throat, an oral appliance makes it easier for you to breathe on your own by subtly shifting jaw position.

Our dentists have a deep understanding of the effect jaw position and bite balance play into multiple dental problems, such as teeth grinding and uneven wear and tear. Our dentists also understand what causes soft tissue collapse at the back of the throat which closes airways and contributes to sleep apnea symptoms.

For obstructive sleep apnea patients, impressions are taken of their bite alignment and sent to a laboratory for the fabrication of a customized dental appliance. We then provide education and information that allows patients to achieve the best results with this treatment method.

Ask our Dentists about Sleep Apnea Diagnosis and Treatment

If you are experiencing extreme daytime fatigue and troubling focusing, you could be affected by lack of quality sleep caused by breathing issues. For diagnosis, contact Drs. Okamoto today to learn more about how our team can help.

8/2/2017 12:00:00 PM

Immediate load implants have provided patients who are missing teeth options for achieving the smiles they want in less time. The concept of teeth-in-a-day takes traditional dental implant surgery and hits the proverbial fast forward button; the patient can immediately benefit from improved aesthetics with concurrent placement of their prosthetics.

If you’re interested in teeth-in-a-day as an efficient way to gain a complete and functional smile, consider how this treatment compares to the alternatives:

Same-Day Smiles: The Basics and Benefits

For patients with a lack of teeth, failing teeth, or minimal healthy teeth, seeking an immediate solution to the problem may be of the utmost importance. Many patients find having dental implants placed the same day as their denture helps alleviate anxiety about the procedure and their appearances.

While traditional implant methods are recommended for many patients, these treatments require time for healing and the use of temporaries before your final prosthetic can be placed. However, teeth-in-a-day offers benefits that include:

• Minimal dental visits
• Same-day implants and restorations look as natural as traditional implant restorations
• You can leave the office with a completely new smile after just one visit

Alternatives: Traditional Implant Methods

Immediate implants and dentures work well for many, but other patients, especially those with complex oral health problems, may be better candidates to have implants installed in the traditional method.  Teeth-in-a-day is ideal for replacing teeth the front of the smile or when several teeth are missing in a row.  Some other factors that affect your ability to receive immediate load implants are:

• Poor bone density in the jaw, requiring a graft as pre-treatment
• Insufficient gum health
• Stress placed on teeth from bruxism or TMD

Preference is as important of a consideration as health when determining if teeth-in-a-day is the right choice for you.  If you are prepared to follow to instructions about caring for your new teeth in the time directly following treatment, you will enjoy best results from care.

Ask Dr. Okamoto about Same-Day Implant Treatment!

Dental implants are a great option for those in search of a healthier, more comfortable smile. With advancements in technology, our prosthodontist helps patients walk out of the office with renewed confidence and dental health after just one appointment.  Call Dr. Okamoto today for your consultation.

7/25/2017 12:00:00 PM

Dental patients with missing teeth may not know the options available for filling in the gaps in their smiles.  While dentures and conventional dental implants are a popular treatment choice, you have an alternative with mini dental implants, also known as MDIs or Narrow Body Implants.  These prosthetics provide benefits for smile improvement and make treatment flexible for qualifying patients.

What are Mini Implants?

Mini implants are made from the same titanium alloy material as conventional implants but are smaller and narrower in size.  While conventional implants are around 3 mm in diameter, MDIs are about half that and just as sturdy.  The solid, one-piece design can prevent the need for a bone graft in some cases, and the procedure is less invasive than conventional implants.  Typically, the process for placing mini implants takes one to two hours under a local anesthetic and has a full recovery time of only a few days.

How Can You Tell if You are a Good Candidate for Mini Implants?

Mini implants aren’t right for everyone, but if you are a patient in need of multiple implants, have degenerative bone that won’t allow for traditional implants or need to secure dentures in place, minis may be the fit for you. Some patients are better suited for the conventional implants but benefit from having a mini implant installed as a temporary fix.  The most significant benefit of minis over conventional implants is the cost; MDIs are often a fraction of the price of traditional implants.

When Conventional Implants Might be a Better Fit

Conventional implants and dentures either can be a better alternative to mini implants depending on your circumstances.  Full-sized implants have a larger surface area, making them more stable, but do require certain bone volume levels for integration.  Conventional implants also consist of separate pieces that are added in phases.  If you suffer from teeth grinding, mini implants are generally not recommended, as the grinding can wear down the implants prematurely.

In the end, one implant is not definitively better than another. Making a decision on what will work for you involves examining your unique health concerns and factors that contribute to implant success.

Dr. Okamoto and his staff want to make sure you know and are comfortable with all the options available to you when it comes to restoration with dental implants.  If you have questions about dental implants, call the helpful staff at Drs. Steven and Michelle Okamoto’s office today!

7/24/2017 12:00:00 PM

Hard tissue grafts are used to repair depleted bone that no longer supports teeth and jaw function. The procedure involves taking tissue from either the patient themselves or a donor and applying it in areas where bone has receded, particularly after tooth loss or complications of osteoporosis. Dr. Okamoto treats bone depletion through comprehensive care that encourages healthy, functional, and beautiful smiles. Grafting is the predominant way bone recession is treated.

Now that you understand bone grafting basics, here’s what else you should about this procedure:

Bone grafts are safe: Tissue used for the graft can be your own, made in a lab, or taken from a donor. All of these are compatible with your natural jaw bone and integrate well. Grafting materials must be certified before they are provided to a patient, so all of them are safe avenues for creating a more supportive oral structure.

Bone grafts restore aesthetic: Bone depletion creates a prematurely aged and sunken appearance. When lost teeth or other health issues affect bone volume, the only way to restore a natural aesthetic is through grafting procedures. Augmenting bone structure restores a full and healthy appearance. Dr. Okamoto provides patient with the completely healthy and natural-looking smiles they deserve; bone graft procedures can give patients the chance at a beautiful smile again.

Bone grafts support better function and treatment results: As bone loss progresses, your teeth may begin to shift out of place, making everyday function uncomfortable and difficult. Loose and unstable teeth are at a higher risk for loss, which compounds bone health problems.  A bone graft bolsters jaw strength and provides security for natural teeth. If you are interested in dental implants to replace lost teeth, a bone graft creates the ideal environment to support lasting treatment success.

Can Bone be Compromised again After a Graft?

Maintaining oral health is dependent on seeking the most beneficial treatment to support bone health and development, as well as replacement for missing teeth. The addition of a bone graft actually encourages the development of new bone in the area, improving more than the region where the graft was placed. If you choose implants to replace lost teeth, you can enjoy the benefits of healthy, dense bone volume with minimized risks for additional bone loss.

Contact us for Comprehensive Treatment for Bone Loss, Missing Teeth, and Dental Implants

Dr. Okamoto and his team are prepared to treat bone health problems and advanced tooth loss through grafting procedures. Contact our office today for more information on whether you can benefit from a bone graft.

7/7/2017 11:29:00 AM

People have been in search of straight, healthy teeth for centuries. Sometime in the 1800s, dentists started making advancements in the production of appliances to adjust teeth alignment. These early treatments were derived from metal and, for much of the next century and a half, this material remained unchanged while the design and use of braces developed.

Metal braces have been improved upon, as orthodontists transitioned from using gold and silver to more cost-effective stainless steel. But within the past decade, the demand for more aesthetically pleasing braces expanded patients’ options. Most popular among these brands is Invisalign, a system of clear, tray-based orthodontics.

If you wish to obtain a straighter smile, consider how you can benefit from this aesthetic option by comparing it to systems of metal orthodontics:

The Old Reliable: Metal Bracket-and-Wire Systems

Many dentists and orthodontists continue to work with metal braces, as the product is dependable and effective. Among patients, the most common motivator to choose metal braces is that they are typically an affordable option, but cost depends on the extent of their needs. 

For children, metal braces are often the default choice. Kids typically lack the discipline to wear and use removable braces with consistency, and the complex bite issues that can manifest as children’s teeth develop are usually best treated with braces.

Inconspicuous and Modern: Invisalign Clear Braces

In the late 20th Century, advancements in orthodontic technology expanded in ways to make braces inconspicuous. While braces with plastic brackets were attempted, they lacked the durability to be instituted as a regular treatment method. Invisalign braces then emerged, combining the function of a retainer with the cosmetic benefits of acrylic. This way, wearers could fix their alignment without the permanence and prominence of metal wires and brackets. 

For many patients, the cost of braces matches the cost of their removable aligner treatment. This is especially alluring if you are dealing with only minor to moderate alignment issues and the idea of full braces to correct that problem feels like over kill. Invisalign is often ideal for adult patients whose lifestyles and careers would be hampered by the visibility of metal braces. As they are highly discreet and removable, Invisalign makes it easy to align teeth without forcing wearers to compromise on their diet and oral health routines.

Invisalign clear braces do not have the same range of use as metal braces.. But for those with the most widespread and common dental issues, Invisalign provides a cosmetic and functional treatment.
If you’re wondering whether Invisalign is right for you, contact Drs. Steven and Michelle Okamoto for your clear braces consultation at their Torrance dental office.

3/28/2017 12:00:00 PM

Sleep apnea is a condition with two potential causes; your sleep-disordered breathing is either a result of soft tissue collapse at the back of your throat, or interruption of communication signals between your brain and body.  Effective treatments for sleep apnea are entirely dependent upon your diagnosis. Consider the following about your needs:

Central Sleep Apnea – CPAP Machine

As central sleep apnea does not involve any physical blockages of airways, CPAP machines are often the most beneficial appliances for treatment.  Even if your brain cannot tell your body to breathe rhythmically while sleeping, Continuous Positive Airway Pressure technology moves air through passageways to ensure deep sleep and prevent snoring. While CPAP is bulky, and utilizes a face mask with adjustable straps to keep it in place, it is the most predictable way to promote positive airflow for CSA sufferers.

Obstructive Sleep Apnea – Oral Appliance Therapy

Because this form of the condition is caused by soft tissues covering airways, solutions are more flexible. Soft tissue blockages can be moved out of the way through the forced air method utilized with CPAP, but many patients with OSA choose a dental night guard or oral appliance for better breathing. These devices reposition your jaw, moving the bottom arch forward slightly, which prevents the closure of breathing passages. Oral appliance therapy is comfortable, as patients can have their night guards custom fitted. There is also less equipment overall with the oral appliance and patient report easier adjustment to this form of treatment, improving compliance rates.

Complex Sleep Apnea Diagnosis

In some cases, a single treatment may not provide the relief the patient is looking for. For instances of complex sleep apnea, CPAP can be used in conjunction with a dental appliance. The appliance keeps airways open and CPAP moves air through the nose and throat. This comprehensive way to treat sleep apnea proves effective for patients dealing with multiple problems that prevent successful sleep breathing.

Ask our Sleep Apnea Dentist How He Can Help

Dr. Okamoto provides both sleep apnea diagnosis and treatment for sleep disordered breathing at his Torrance dental office. If you have questions about which treatment will work best for you, contact our office for a consultation. Part of your treatment includes at-home sleep monitoring, so there are no additional visits to a sleep study program.

3/16/2017 12:00:00 PM

You may have heard, time and time again, that sugary foods, drinks, and non-nutritional snacks are bad for your teeth. Though you may not question this logic, it’s important to understand what role your diet plays in your oral health.

One of the many diseases that Dr. Okamoto works to treat is periodontitis, a common yet preventable disease characterized by bleeding gums and brought on by bacteria attacking the tooth enamel and soft tissue. Although many believe the primary cause of gum disease to be poor oral hygiene, evidence also shows a correlation between diet and the onset of periodontitis.

What Foods Are You Eating in Excess?

Research suggests that diets rich in carbohydrates lead to more cases of gum disease. That’s because the sugars contained in carbohydrates become sticky, adhering to tooth enamel and allowing bacteria to spread. Combine large amounts of carbohydrates with poor oral hygiene practices and the bacteria on your teeth start to impact your gums as well.

As you work to improve your oral health, be mindful of the foods you consume. Of course, even the healthiest of foods contain some sugar, but the added sugars in many processed foods are what will do your teeth and gums the most harm. Read ingredient labels, and if you must indulge in your favorite treat, make sure to brush and floss thoroughly afterward.

What Foods Aren’t You Eating Enough Of?

While you’re limiting the amount of sugar you eat, it's also essential that you take in certain nutrients, such as vitamins, minerals and antioxidants, which are good for your body overall and support a healthy diet. Without them, your immune system may weaken and allow certain infections to spread.

When your diet lacks particular nutrients, periodontal disease may have an easier time affecting your gums. For this reason, a balanced diet is important to maintain. Fruits, vegetables and dairy products contain vitamins and minerals that benefit your oral health if eaten regularly. Proteins are also important for the strength of your tooth enamel.

Preventing Periodontal Disease Starts With You!

With a balanced diet, good oral hygiene practices, and regular dental checkups, you can keep periodontal disease at bay. If you would like more information about periodontal disease, contact Dr. Okamoto to schedule an appointment.

2/27/2017 12:00:00 PM

Your teeth and gums harbor bacteria that are typically disrupted and removed with daily brushing and flossing. When not properly cleaned, however, bacteria cause soft tissue infection, plaque and calculus buildup, and decay of tooth structures. Treatments for periodontal disease vary from non-invasive to surgical, and each has their own benefits to oral health.

Dr. Okamoto provides non-surgical gum treatments to patients with mild to moderate signs of gum problems and help patients understand when more extensive care may be necessary.

Non-surgical Treatments

These procedures do not involve incisions into gums or the removal of tissue. Rather, they focus on leaving gums and teeth intact and promote recovery after initial signs of infection. Dr. Okamoto treats existing issues and staves off further infection with deep cleaning procedures and the use of antibiotics.

The most common non-surgical treatment for periodontal disease is a comprehensive cleaning that targets the area below the gum line. In this procedure, bacteria are removed and the teeth are made clean and smooth, so bacteria cannot easily adhere to tooth roots. After receiving this treatment, many patients will require continued maintenance to keep the gums infection-free. This deep cleaning process may be used before surgical treatments as a preparatory procedure.

For continued gum health, patients cane recommended periodontal trays with beneficial medication. These custom trays, much like the ones used for teeth whitening, deliver antibiotics and other medicines. They are made to fit snugly on the teeth and let the medicine seep into gums to fight off bacteria. Used in conjunction with other non-surgical treatments, this is one way patients can support in-office care with at-home hygiene.

When are Surgical Treatments Necessary?

In some severe cases, periodontal disease affected bone and caused significant tissue recession, requiring more comprehensive treatment. In these cases, care of your smile may be referred to a gum specialist. Some procedures restore the smile after gums and teeth have been damaged by gum disease include:.

Pocket Reduction – Your dentist will gently pull gum tissue away from the tooth, cleaning its surface and beneath. The goal is to reduce the size of the periodontal pocket that has allowed food to get trapped and bacteria to grow.

Gum and Bone Grafting – When gingival decay has reduced the support of gums or bone, a synthetic or natural tissue can be used to cover exposed roots. This can reduce sensitivity, improve an uneven smile, and restore confidence in your oral health.

Dental Prosthetics – If teeth are lost due to advanced periodontitis, it doesn’t mean you can’t have a full smile again. Dental implants are biocompatible and fuse to the bone, providing a strong foundation for a personalized dental restoration. Crowns, bridges, and dentures are all supported by this innovative procedure.  If you’ve been affected by serious periodontal disease and are looking for restorations, Dr. Okamoto is a prosthodontic specialist and provides prosthetic teeth to restore oral health and function.

Contact Dr. Okamoto Today for Periodontal Treatment and Restoration

We are here to help you enjoy a healthier smile for a lifetime. If you have symptoms of periodontal disease, or are experience significant oral discomfort, call us today for information on gum disease treatment for dental rejuvenation with prosthetics.

Providing Advanced Dentistry in Torrance for More Than 30 Years

Steven K. Okamoto, DDS
Michelle Okamoto, DDS

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